title: Ultrasound biofeedback treatment for persisting childhood apraxia of speech.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of a treatment program that includes ultrasound biofeedback for children with persisting speech sound errors associated with childhood apraxia of speech (CAS).
  
  
  METHODS
  Six children ages 9-15 years participated in a multiple baseline experiment for 18 treatment sessions during which treatment focused on producing sequences involving lingual sounds. Children were cued to modify their tongue movements using visual feedback from real-time ultrasound images. Probe data were collected before, during, and after treatment to assess word-level accuracy for treated and untreated sound sequences. As participants reached preestablished performance criteria, new sequences were introduced into treatment.
  
  
  RESULTS
  All participants met the performance criterion (80% accuracy for 2 consecutive sessions) on at least 2 treated sound sequences. Across the 6 participants, performance criterion was met for 23 of 31 treated sequences in an average of 5 sessions. Some participants showed no improvement in untreated sequences, whereas others showed generalization to untreated sequences that were phonetically similar to the treated sequences. Most gains were maintained 2 months after the end of treatment. The percentage of phonemes correct increased significantly from pretreatment to the 2-month follow-up.
  
  
  CONCLUSIONS
  A treatment program including ultrasound biofeedback is a viable option for improving speech sound accuracy in children with persisting speech sound errors associated with CAS.
authors.affiliation: Correspondence to Jonathan Preston: preston@haskins.yale.edu.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Preston
authors.forename: Nickole
authors.initials: N
authors.lastname: Brick
authors.forename: Nicole
authors.initials: N
authors.lastname: Landi
mesh_terms: D000293:Adolescent; D001072:Apraxias / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001676:Biofeedback, Psychology / Q000379:methods*; D002648:Child; D003463:Cues; D056228:Feedback, Sensory / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010700:Phonetics; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D013070:Speech Therapy / Q000379:methods; D014059:Tongue / Q000000981:diagnostic imaging / Q000502:physiology; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*; D014463:Ultrasonography
keywords: articulation; childhood apraxia of speech; children; efficacy; intervention; speech sound disorders